Do soldiers seek more mental health care after deployment? Analysis of mental health consultations in the Netherlands Armed Forces following deployment to Afghanistan

Background: Military deployment to combat zones puts military personnel to a number of physical and mental challenges that may adversely affect mental health. Until now, few studies have been performed in Europe on mental health utilization after military deployment. Objective: We compared the incidence of mental health consultations with the Military Mental Health Service (MMHS) of military deployed to Afghanistan to that of non-deployed military personnel. Method: We assessed utilization of the MMHS by the full cohort of the Netherlands Armed Forces enlisted between 2008 and 2010 through linkage of mental health and human resource information systems. Results: The total population consisted of 50,508 military (18,233 deployed, 32,275 non-deployed), who accounted for 1,906 new consultations with the MMHS. The follow-up was limited to the first 2 years following deployment. We observed higher mental health care utilization in deployed vs. non-deployed military personnel; hazard ratio (HR), adjusted for sex, military branch and time in service, 1.84 [95% CI 1.61–2.11] in the first and 1.28 [1.09–1.49] in the second year after deployment. An increased risk of adjustment disorders (HR 2.59 [2.02–3.32] and 1.74 [1.30–2.32]) and of anxiety disorders (2.22 [1.52–3.25] and 2.28 [1.50–3.45]) including posttraumatic stress disorder (5.15 [2.55–10.40] and 5.28 [2.42–11.50]), but not of mood disorders (1.33 [0.90–1.97] and 1.11 [0.68–1.82]), was observed in deployed personnel in the first- and second-year post-deployment, respectively. Military personnel deployed in a unit with a higher risk of confrontation with potentially traumatic events had a higher HR (2.13 [1.84–2.47] and 1.40 [1.18–1.67]). Conclusions: Though absolute risk was low, in the first and second year following deployment to Afghanistan there was an 80 and 30% higher risk for mental health problems resulting in a consultation with the Dutch MMHS compared to military never deployed to Afghanistan. These observations underscore the need for an adequate mental health infrastructure for those returning from deployment

Revision of Oxandra (Annonaceae)

A taxonomic revision is given of the Neotropical genus Oxandra (Annonaceae). Within the genus 27 species are recognized, 4 of which are new to science. Most of the species are occurring in tropical South America, whereas a few (6) are found in Mexico and Central America and two in the West Indies (Greater and Lesser Antilles). A key to all species is provided. The treatment includes chapters about the history of the genus and morphology. All species are fully described, including full synonymy, notes on distribution and ecology, field observations (when available), vernacular names (when given), and mostly short notes about relationships of the species concerned. For each species a distribution map is made. At the end of the revision a complete list of vernacular names is included.Peer reviewe

Synergistic effects of bombesin and epidermal growth factor on cancers.

Bombesin and gastrin-releasing peptide act as autocrine mitogens in various cancers. Bombesin antagonist RC-3095 inhibited growth in some cancers and slowed the progression of premalignant lesions, possibly by down-regulating epidermal growth factor (EGF) receptors. Since the EGF receptor mitogen response involves tyrosine kinase stimulation, we tested the hypotheses that bombesin stimulates, and RC-3095 inhibits, phosphorylation; EGF and bombesin promote the phosphorylation of the same substrates; and EGF and bombesin act synergistically on phosphorylation. Therefore, in vitro assays for phosphorylation were performed in the presence or absence of EGF, bombesin, RC-3095, and combinations in samples derived from tumor, tissue surrounding tumor, cell lines, and normal and transforming tissue derived from the 9,10-dimethyl-1,2-benzanthracene-induced squamous cell lesions of the hamster cheek pouch. Bombesin increased, and RC-3095 decreased, phosphorylation in these samples. In the human hepatoma sample and surrounding tissue, these ligands altered the phosphorylation of the same substrates affected by EGF. EGF and bombesin stimulated phosphorylation synergistically in the hamster samples and the hepatoma. Bombesin-induced phosphorylation was greater in tissue surrounding the hepatoma, whereas RC-3095 was more effective in inhibiting phosphorylation in the hepatoma itself. This cancer, therefore, could be endogenously stimulated by gastrin-releasing peptide. These observations support the hypothesis that bombesin stimulates growth of tissues and tumors by amplifying the phosphorylation response to EGF. The growth inhibitory response to RC-3095, or other bombesin analogues, of individual tumors may be prognosed by in vitro phosphorylation assays using the samples from the patient's tumor

Using synchronizing heuristics to construct homing sequences

Computing a shortest synchronizing sequence of an automaton is an NP-Hard problem. There are well-known heuristics to find short synchronizing sequences. Finding a shortest homing sequence is also an NP-Hard problem. Unlike existing heuristics to find synchronizing sequences, homing heuristics are not widely studied. In this paper, we discover a relation between synchronizing and homing sequences by creating an automaton called homing automaton. By applying synchronizing heuristics on this automaton we get short homing sequences. Furthermore, we adapt some of the synchronizing heuristics to construct homing sequences

Las instituciones científico-medicas en la Murcia del XVIII : un intento fracasado de renovación de la formación médica

Presentamos un estudio sobre dos intentos que, en la Murcia del siglo XVIII, pretendieron mejorar y actualizar la formación que recibían los profesionales sanitarios. Ambos fracasaron, aparentemente por falta de acuerdo entre sus promotores, si bien pensamos que las causas fueron más profundas y habría que buscarlas en la escasa actividad científica que se desarrolló en la ciudad, lo que hacía innecesaria la existencia de instituciones docentes o de otras como las Academias de Medicina

Electronic and bite angle effects in catalytic C-O bond cleavage of a lignin model compound using ruthenium xantphos complexes

The authors would like to thank the EPSRC (Global Engagement grant EP/K00445X/1 and critical mass grant EP/J018139/1) and the European Union (Marie Curie ITN ‘SuBiCat’ PITN-GA-2013-607044) for financial support. NMSF-Swansea and Mr. Stephen Boyer are kindly acknowledged for mass spectrometry and elemental analysis, respectively.Bite angle and electronic effects on the ruthenium-diphosphine catalysed ether bond cleavage of the lignin β-O-4 model compound 2-phenoxy-1-phenethanol were tested. Enhanced conversion of the substrate was observed with increasing σ-donor capacity of the ligands. Kinetic and thermodynamic data suggest oxidative addition of the dehydrogenated model compound to the diphosphine Ru(0) complex to be rate-limiting.PostprintPeer reviewe

Assessing the efficacy and cost of detergents used in a primary care automated washer disinfector

Background: Cleaning of re-usable medical devices is a critical control point in the decontamination cycle, although defined end-points of the process are controversial. Objective: Investigate cleaning efficacy and cost of different detergent classes in an automated washer disinfector (AWD) designed for dental practice. Methods: Loads comprised test soiled dental hand instruments in cassettes and extraction forceps. Residual protein assayed using the International standard method (ISO 15883-5:2005) 1% SDS elution with ortho-phthalaldehyde (OPA) or GBox technology (on instrument OPA analysis). Short (60 minutes) and long (97 minutes) AWD cycles were used with four different classes of detergents, tap water and reverse osmosis water. Results: SDS elution analysis (N = 612 instruments) demonstrated four detergents with both wash cycles achieved equivalent cleanliness levels and below a threshold of 200 μg protein/instrument. GBox methodology (N = 575) using UK Department of Health threshold of 5 μg/instrument side demonstrated that tap water performed with the greatest efficacy for all types of instruments and cycle types. Conclusions: Using International standard methodology, different detergent classes had equivalence in cleaning efficacy. Cheaper detergents used in this study performed with similar efficacy to more expensive solutions. Findings emphasise the importance of validating the detergent (type and concentration) for each AWD